Larry Downing/Reuters Study co-author Dr. Tom Jefferson says
he "can't see any reason" for vaccinating anyone against flu --
arguing the shots did nothing to save lives -- and that most
influenza-vaccine studies are ...

A new Canadian-led study has added to a simmering
scientific dispute over flu-shot campaigns, concluding that immunizing
nursing-home workers does nothing to cut the number of confirmed
influenza cases among the homes' elderly residents.

Coming at the end
of the largest flu-vaccination campaign in Canadian history, the review
of previous studies calls for stepped-up research into alternative,
lower-tech ways to combat the virus, such as improved hand washing.

"What troubled us is that [shots] had no effect on
laboratory-confirmed influenza," said Dr. Roger Thomas of the University
of Calgary, lead author of the paper published by the respected Cochrane
Library.

"What we were looking for is proof that influenza ... is decreased.
Didn't find it. We looked for proof that pneumonia is reduced. Didn't
find it. We looked for proof deaths from pneumonia are reduced. Didn't
find it."

A prominent flu expert, however, calls the authors' conclusions
misleading, noting that vaccinating workers does, in fact, lessen the
amount of influenza-like sickness and the number of deaths from all
causes among those nursing-home denizens. That is all that really
matters, said Dr. Allison McGeer, infectious disease specialist at
Toronto's Mount Sinai Hospital.

"There is [very little] that you or I can do that is more effective
at preventing deaths than vaccinating health-care workers in long-term
care facilities," she said. "That's the bottom line .... There is no
question."

The studies could not accurately gauge the effect of vaccination on
actual laboratory-confirmed flu cases in nursing homes, because so few
residents are tested, added Dr. McGeer. If labs had examined specimens
from everyone in the studies, the results would likely have shown a
reduction in confirmed flu cases, too, she said.

The new paper's co-author is Dr. Tom Jefferson, a British
epidemiologist who heads vaccine research for the respected Cochrane
Collaboration -- and who has earned a reputation as a scientific
dissident for his outspoken criticism of flu vaccination.

In media interviews last year, Dr. Jefferson was quoted as saying he
"can't see any reason" for vaccinating anyone against flu -- arguing the
shots did nothing to save lives -- and that most influenza-vaccine
studies are "rubbish."

Dr. McGeer said she finds it "mind boggling" that medical journals
that publish Dr. Jefferson's work do not question his provocative
analyses.

"Scientists are passionate about what they do. All of us have belief
systems and sometimes, as with any human endeavour, your belief system
overwhelms the scientific evidence," she said. "The purpose of
scientific method, the purpose of publication is to get back the
objectivity ... And we are not doing that effectively with Dr.
Jefferson."

The stakes in the debate are high. Governments spent more than
$400-million on acquiring H1N1 pandemic vaccine for Canadians. The
Ontario government alone spends about $23-million annually in providing
seasonal-flu shots free to anyone who wants them.

Public health and hospital officials have also
lobbied hard to increase the percentage of health-care workers who
get vaccinated, with a handful of Canadian facilities making the
practice mandatory for their staff.

The Public Health Agency of
Canada, which oversaw the pandemic flu battle, will study the
Cochrane review's findings carefully, said Nadia Mostafa, an agency
spokeswoman. The agency recognizes that "it is not effective to only
immunize and not take any other infection-prevention measures," she
noted.

The review by Dr. Thomas and Dr. Jefferson analyzed five studies
on the issue conducted between 1997 and 2009 -- four of them
randomized, controlled trials -- using guidelines set out by
Cochrane, which does systematic reviews of the effects of drugs and
other health measures.

They concluded that vaccinating staff had no proven impact on the
amount of laboratory-confirmed flu cases among elderly residents,
the number of related pneumonia cases or pneumonia-linked deaths,
which the authors said would be the most direct outcomes of flu-shot
campaigns.

Dr. Thomas underlined his study's call for high-quality research
into other anti-flu measures, such as enhanced use of hand washing,
face masks, early detection of the virus with nose swabs and
quarantining nursing-homes.

He said he aggressively encouraged such strategies during a
previous role as director of long-term care homes in Ottawa, and the
facilities' death rates were among the lowest in the city.